Bassett and Cofield asked whether there is a best time to repair an acute traumatic cuff tear, comparing repair within 3 weeks, at 3 to 6 weeks and at 6 to 12 weeks after injury.
Retrospective Mayo Clinic series of 37 acute full‑thickness tears repaired within 3 months of injury, 1954 to 1978, followed a mean 7 years.
Key Findings
Final active abduction averaged 168° after repair within 3 weeks, 126° at 3 to 6 weeks and 129° at 6 to 12 weeks. The gain in the earliest group (140°) was significantly larger.
Pain relief was acceptable whatever the timing: at follow‑up 13 had no pain and 24 slight pain.
Tear size did not significantly change final abduction (148° small, 152° medium, 133° large).
Strength was better with repair within 6 weeks and with small or medium tears, but neither difference was significant.
Of 21 shoulders with films before and after surgery, upward humeral subluxation never decreased. At follow‑up, glenohumeral arthritis was mild in 9, moderate in 2 and severe in 1 of the 27 shoulders with films.
Board pearl
Repair within three weeks gave the best abduction. The groups were small (12, 6 and 19) and not randomized, and repair at 3 to 6 weeks averaged about the same abduction as repair at 6 to 12 weeks.
Bassett and Cofield asked whether there is a best time to repair an acute traumatic cuff tear, comparing repair within 3 weeks, at 3 to 6 weeks and at 6 to 12 weeks after injury.
Retrospective Mayo Clinic series of 37 acute full‑thickness tears repaired within 3 months of injury, 1954 to 1978, followed a mean 7 years.
Key Findings
Final active abduction averaged 168° after repair within 3 weeks, 126° at 3 to 6 weeks and 129° at 6 to 12 weeks. The gain in the earliest group (140°) was significantly larger.
Pain relief was acceptable whatever the timing: at follow‑up 13 had no pain and 24 slight pain.
Tear size did not significantly change final abduction (148° small, 152° medium, 133° large).
Strength was better with repair within 6 weeks and with small or medium tears, but neither difference was significant.
Of 21 shoulders with films before and after surgery, upward humeral subluxation never decreased. At follow‑up, glenohumeral arthritis was mild in 9, moderate in 2 and severe in 1 of the 27 shoulders with films.
Board pearl
Repair within three weeks gave the best abduction. The groups were small (12, 6 and 19) and not randomized, and repair at 3 to 6 weeks averaged about the same abduction as repair at 6 to 12 weeks.